Category:SRC Clinic Provider Orientation - Revision history

JenniferH at 21:45, 30 August 2019

2019-08-30T21:45:34Z

← Older revision		Revision as of 21:45, 30 August 2019
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	Once things settle down, give the baby a Vitamin K shot. Mom and baby will probably be traveling by commercial or medevac plane to Bethel, as both need to be observed—baby for 48 hours.		Once things settle down, give the baby a Vitamin K shot. Mom and baby will probably be traveling by commercial or medevac plane to Bethel, as both need to be observed—baby for 48 hours.

	===[[Death Protocol\|~~Deaths~~]]===		===[[Death Protocol\|Death in Village]]===
	People do die in the village. When this occurs they will need a provider to pronounce them dead and document it and call the State Troopers/VPSO and the Medical Examiner and North Wing Provider on call, so they can start the paperwork process and death certificate.		People do die in the village. When this occurs they will need a provider to pronounce them dead and document it and call the State Troopers/VPSO and the Medical Examiner and North Wing Provider on call, so they can start the paperwork process and death certificate.

JenniferH at 21:45, 30 August 2019

2019-08-30T21:45:00Z

← Older revision		Revision as of 21:45, 30 August 2019
Line 110:		Line 110:
	Once things settle down, give the baby a Vitamin K shot. Mom and baby will probably be traveling by commercial or medevac plane to Bethel, as both need to be observed—baby for 48 hours.		Once things settle down, give the baby a Vitamin K shot. Mom and baby will probably be traveling by commercial or medevac plane to Bethel, as both need to be observed—baby for 48 hours.

	===[[Death ~~in Village~~\|Deaths]]===		===[[Death Protocol\|Deaths]]===
	People do die in the village. When this occurs they will need a provider to pronounce them dead and document it and call the State Troopers/VPSO and the Medical Examiner and North Wing Provider on call, so they can start the paperwork process and death certificate.		People do die in the village. When this occurs they will need a provider to pronounce them dead and document it and call the State Troopers/VPSO and the Medical Examiner and North Wing Provider on call, so they can start the paperwork process and death certificate.

Mfaubion: /* Deaths */

2019-07-31T21:37:45Z

Deaths

← Older revision		Revision as of 21:37, 31 July 2019
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	People do die in the village. When this occurs they will need a provider to pronounce them dead and document it and call the State Troopers/VPSO and the Medical Examiner and North Wing Provider on call, so they can start the paperwork process and death certificate.		People do die in the village. When this occurs they will need a provider to pronounce them dead and document it and call the State Troopers/VPSO and the Medical Examiner and North Wing Provider on call, so they can start the paperwork process and death certificate.

	If this was an expected death, an [[media:~~Expected-Home-Death-Form-020905~~.pdf\|Expected Home Death form]] can be filled out ahead of time and faxed to the State Troopers and the Medical Examiner, making it very simple on the day of the actual death.		If this was an expected death, an [[media:Expected_home_death.pdf\|Expected Home Death form]] can be filled out ahead of time and faxed to the State Troopers and the Medical Examiner, making it very simple on the day of the actual death.

	If this was not done, you will need to have more details for the officers and ME. Go to the scene of the demised patient, call him using his/her name, examine her eyes, feel for breath, and listen for breath sounds and heartbeat for approximately 30 seconds. If nothing, he is officially pronounced dead at that time.		If this was not done, you will need to have more details for the officers and ME. Go to the scene of the demised patient, call him using his/her name, examine her eyes, feel for breath, and listen for breath sounds and heartbeat for approximately 30 seconds. If nothing, he is officially pronounced dead at that time.

Mfaubion: /* Job Description/Duties */

2019-06-17T22:25:33Z

Job Description/Duties

← Older revision		Revision as of 22:25, 17 June 2019
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	==Job Description/Duties==		==Job Description/Duties==

	[[~~NEED DUTIES AND HOURS HERE~~]]		[[Job Duties\|Job Descriptions]]
	===ON CALL===		===ON CALL===
	You will be seeing patients during the day, but on call on nights and weekends for emergencies. Our health aides will be on first call but will call you if they need additional help or approval of their plan. You may not have to come in but you need to be available to talk to them. Some SRCs have working cell phones to make this easier. Some villages (Aniak at this point) have a working ambulance that will bring patients directly to the clinic for you to see.		You will be seeing patients during the day, but on call on nights and weekends for emergencies. Our health aides will be on first call but will call you if they need additional help or approval of their plan. You may not have to come in but you need to be available to talk to them. Some SRCs have working cell phones to make this easier. Some villages (Aniak at this point) have a working ambulance that will bring patients directly to the clinic for you to see.

JenniferH at 22:38, 10 June 2019

2019-06-10T22:38:51Z

← Older revision		Revision as of 22:38, 10 June 2019
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	Kids with a Cath proven UTI need treatment for their UTI and then look at the Peds UTI guidelines to see what the next steps are.		Kids with a Cath proven UTI need treatment for their UTI and then look at the Peds UTI guidelines to see what the next steps are.

	===Lab===		===[[Lab]]===
	~~Link to [[:category:Ancillary Services\|Ancillary Services]]~~

	Labs in Bethel include cultures, comprehensive chemistries, CBC, etc. Viral loads and some specialized tests need to be sent to Lab Corp and are not quickly available.		Labs in Bethel include cultures, comprehensive chemistries, CBC, etc. Viral loads and some specialized tests need to be sent to Lab Corp and are not quickly available.

Mfaubion: /* Medevacs SRC Paperwork and Process */

2016-07-08T20:55:25Z

Medevacs SRC Paperwork and Process

← Older revision		Revision as of 20:55, 8 July 2016
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	At times you will have a patient arrive who is too sick to stay at the SRC. You will need to care for the patient and initiate a medevac. Evaluate the patient, have the health aide start your treatment plan—i.e. start an IV and bolus fluids, and call the ER to consult and initiate the medevac. Once the ER agrees, you can call the Anchorage dispatch center, 800-478-5433 and they will call the Bethel crew to get ready and come, or the ER can do that for you. If there are weather delays, the dispatch center will let you know. You will have to handle the patient until the Medevac comes, which is a plane with two paramedics and much equipment.		At times you will have a patient arrive who is too sick to stay at the SRC. You will need to care for the patient and initiate a medevac. Evaluate the patient, have the health aide start your treatment plan—i.e. start an IV and bolus fluids, and call the ER to consult and initiate the medevac. Once the ER agrees, you can call the Anchorage dispatch center, 800-478-5433 and they will call the Bethel crew to get ready and come, or the ER can do that for you. If there are weather delays, the dispatch center will let you know. You will have to handle the patient until the Medevac comes, which is a plane with two paramedics and much equipment.

	There is a [[media:ridealong-release-form.pdf\|consent form]], and a [[media:ptos.pdf\|Patient Transfer Order Form]] you will need to fill out. I really recommend that you use your PCC, but then document all vitals , your secondary exam on extra pages and the flow sheet. If you are able to write a transfer summary, that is helpful, but not essential. All meds need to be documented. Before the patient is handed off to the Medevac crew you need to do a second exam and document how the patient is doing. '''You also need to document the time that the medevac is initiated and that the physician was consulted with, what time the team arrived and what time they left.'''		There is a [[media:ridealong-release-form.pdf\|consent form]], and a [[media:ptos.pdf\|Patient Transfer Order Form]] you will need to fill out. I really recommend that you use your PCC, but then document all vitals, your secondary exam on extra pages and the flow sheet. If you are able to write a transfer summary, that is helpful, but not essential. All meds need to be documented. Before the patient is handed off to the Medevac crew you need to do a second exam and document how the patient is doing. '''You also need to document the time that the medevac is initiated and that the physician was consulted with, what time the team arrived and what time they left.'''

	At times the patient is so severely ill or damaged that you know that they will need to go directly to Anchorage if possible. If you are in St. Mary’s, Aniak, or Emmonak, that may be possible. If the patient is going to need surgery, i.e. a gunshot wound, or is already intubated it may make more sense for them to go straight to ANMC. Discuss it with the Bethel ER and they or you can contact ANMC directly, talk to the ~~Surgeon~~ or ~~Internal Medicine~~ MD and get it initiated. If that happens, the nurse supervisor from ANMC should call you within 10-30 minutes to say they have sent the medevac. If that doesn’t happen, call ANMC back to make sure it is on its way.		At times the patient is so severely ill or damaged that you know that they will need to go directly to Anchorage if possible. If you are in St. Mary’s, Aniak, or Emmonak, that may be possible. If the patient is going to need surgery, i.e. a gunshot wound, or is already intubated it may make more sense for them to go straight to ANMC. Discuss it with the Bethel ER and they or you can contact ANMC directly, talk to the surgeon or internal medicine MD and get it initiated. If that happens, the nurse supervisor from ANMC should call you within 10-30 minutes to say they have sent the medevac. If that doesn’t happen, call ANMC back to make sure it is on its way.

	Sometimes the patient has been stabilized and time is of the essence and the medevac team may ask you to do a ~~Runway~~ transfer, bringing the patient to the runway for quicker turnaround time. If this is the case, get a copy of all paperwork to give the team and get them to the runway.		Sometimes the patient has been stabilized and time is of the essence and the medevac team may ask you to do a runway transfer, bringing the patient to the runway for quicker turnaround time. If this is the case, get a copy of all paperwork to give the team and get them to the runway.

	[[Example of Good Medevac Documentation]]		[[Example of Good Medevac Documentation]]

Mfaubion: /* Deaths */

2016-05-25T23:39:02Z

Deaths

@@ Line 121: / Line 121: @@
 # Medical Examiner, 1-888- 332-3273.
 # North Wing Doc 907-543-6300.
-[[Example of a Good Free Text Death Note]]
+===Example of a Good Free Text Death Note===
 ===Pediatrics===

Mfaubion: /* Chronic Pediaric Patients */

2015-12-04T20:03:59Z

Chronic Pediaric Patients

← Older revision		Revision as of 20:03, 4 December 2015
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	Kids with culture proven UTI, need treatment for their UTI once the culture results are back. If the patient is stable, they will not get ABX until the cx results are back. See the new pediatric UTI guideline. Remember that dysuria without urgency and increased frequency, in the 2-7 year old patients, is most often due to vulvovaginitis and can be treated with sitz baths, A&D ointment and improved hygiene.		Kids with culture proven UTI, need treatment for their UTI once the culture results are back. If the patient is stable, they will not get ABX until the cx results are back. See the new pediatric UTI guideline. Remember that dysuria without urgency and increased frequency, in the 2-7 year old patients, is most often due to vulvovaginitis and can be treated with sitz baths, A&D ointment and improved hygiene.

	===Chronic ~~Pediaric~~ Patients===		===Chronic Pediatric Patients===
	We have a pediatrician on call every day for the inpatient peds patients and for consults. A Chronic Pediatric Patient is a complicated kid, who may be a preemie, or twin, or have a chronic serious illness that is being managed by a pediatrician. If you see a Chronic Pediatric Patient in the SRC, you must consult the Peds on call for a treatment plan before the child leaves the building. You can tell a patient is a chronic peds patient by looking at their problem list under the registries and seeing Chronic Peds. You can also tell by looking at their sticker and seeing if they have a pediatrician listed for their pod. If it is an animal, bird, or fish pod name they are not chronic peds.		We have a pediatrician on call every day for the inpatient peds patients and for consults. A Chronic Pediatric Patient is a complicated kid, who may be a preemie, or twin, or have a chronic serious illness that is being managed by a pediatrician. If you see a Chronic Pediatric Patient in the SRC, you must consult the Peds on call for a treatment plan before the child leaves the building. You can tell a patient is a chronic peds patient by looking at their problem list under the registries and seeing Chronic Peds. You can also tell by looking at their sticker and seeing if they have a pediatrician listed for their pod. If it is an animal, bird, or fish pod name they are not chronic peds.

Mfaubion: /* Links */

2015-11-25T22:03:36Z

Links

← Older revision		Revision as of 22:03, 25 November 2015
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	===Links===		===Links===
	[[Maps\|Map of Subregional Clinic service areas in the YK Delta]]		[[Maps\|Map of Subregional Clinic service areas in the YK Delta]]<br>
	[[media:SRCGuide.pdf\|Subregional Clinic Guide]]		[[media:SRCGuide.pdf\|Subregional Clinic Guide]]

Mfaubion: /* Specialty Visits */

2015-11-25T22:02:25Z

Specialty Visits

← Older revision		Revision as of 22:02, 25 November 2015
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	===Specialty Visits===		===Specialty Visits===
	Along with regular on-site clinics other specialty clinics that are provided at SRC include regular optometry visit for contact and glasses fittings and quarterly physical therapist visits. Portable mammogram clinics are scheduled at each Subregional Clinic. So are Diabetic clinics for “one stop care” for diabetics in the region. Other specialty clinics include audiology and colonoscopy.		Along with regular on-site clinics other specialty clinics that are provided at SRC include regular optometry visit for contact and glasses fittings and quarterly physical therapist visits. Portable mammogram clinics are scheduled at each Subregional Clinic. So are Diabetic clinics for “one stop care” for diabetics in the region. Other specialty clinics include audiology and colonoscopy.

			===Links===
			[[Maps\|Map of Subregional Clinic service areas in the YK Delta]]
			[[media:SRCGuide.pdf\|Subregional Clinic Guide]]

	==Clinic Description==		==Clinic Description==